Quasi-colonial bodies: an analysis of the reproductive lives of poor black and racially subjugated women.

This Article analyzes the relationship between the struggle for the recognition of Black women's reproductive rights in the United States and the fight for racial justice. Specifically, it argues that the problematization of poor Black women's fertility--evidenced by the depiction of single Black motherhood as a national crisis, (1) the condemnation of poor Black women who rely on public assistance, (2) and the portrayal of their children as an embryonic "criminal class" (3)--ought to be understood as a form of contempt for Black women's reproductive rights. (4) Differently stated, the lack of acknowledgment in legal, political, and popular discourse that motherhood is a legitimate choice for poor Black women demonstrates that their right to reproduce is disparaged. Further, this censure of poor Black women's fertility ought to be understood not only as a failure of the reproductive rights movement, but also as a matter of racial injustice. That is, the struggle of poor Black women to have their reproductive choices respected is a struggle for racial equality.

Conceptualizing Black women's reproductive rights struggles as a racial injustice may seem counterintuitive. This is in part due to the widespread exclusion of gender-related issues from social movements for racial equality. (5) Many Black feminists have noted that the paradigmatic subject of racial justice movements has been the Black man, while the paradigmatic subject of gender justice movements has been the White woman. (6) As political scientist Shatema Threadcraft recently commented, "that our understanding of contemporary race problems is dominated by issues of criminal justice and public education, and that our understanding of gender politics assumes that the biggest struggles that women have faced are around access to legitimate public roles, reveals troubling gender and racial bias, respectively." (7)

In a similar vein, legal theorist Dorothy Roberts recounts an incident where she was asked to speak at a forum entitled Civil Rights Under Attack." Recent Supreme Court Decisions. (8) After giving a speech addressing obstacles facing Black women in their struggle for reproductive autonomy, Roberts was criticized by a male audience member, who admonished her to "stick to traditional civil rights concerns, such as affirmative action, voting rights, and criminal justice." (9) This list of civil rights priorities reveals a Black male subject--the subject for whom matters of racial justice have historically, and now intuitively, been thought to concern. This paper seeks to regender the subject of racial justice movements and to comprehend the denial of Black women's reproductive rights as a contemporary race problem.

Two conceptualizations of race influence this paper. The first is a commonsensical understanding of race, which conceives of it as a visually distinct expression of phenotype. In Parts I and II, this definition of race predominates. Thus, references to "Black women" here refer to women who are Black because they possess the skin color, facial features, and hair texture that are commonly associated with the "Black race." (10) However, subsequent Parts rely on a more expansive understanding of race--using the term to denote categories of phenotypic expression as well as relative stations of marginalization and privilege. As Cheryl Harris aptly explains:

"Black" and "White" signify ideological concepts and do not operate as phenotypic markers.... [They] are relationally constructed. Whiteness is the position of relative privilege marked by distance from Blackness; Blackness, on the other hand, is a legal and social construction of disadvantage and subordination marked by the distance from White privilege. (11) Accordingly, Blackness is a position occupied not only by women who are "Black" because their appearance accords with historical understandings of race, but also those who, for sundry reasons, find themselves disqualified from White privilege. Under this definition, poor women, immigrant women, and women who receive welfare can all be understood to occupy a certain degree of Blackness, irrespective of their racial ascriptions. (12) This Article uses the term "racially subjugated women"--referring to phenotypically Black women as well as unprivileged women of all races--to denote this expanded notion of race. It is important to note that this broad conception of race is not reducible to class; more affluent women and men who are phenotypically Black are not stripped of their Blackness by virtue of their wealth or education level. Stated differently, Black racial ascription is a mark that, regardless of the class status of the individual, disqualifies those so marked from enjoying the privileges associated with Whiteness. (13) Accordingly, Blackness denotes the experience of marginalization shared by all persons who, because of phenotype, belong to the socially constructed "Black race," as well as the experience of those who lack privilege due to poverty or immigration status, among other things. However, that said, this Article only discusses the reproductive lives of poor women--leaving discussion about wealthy Black women for another article.

This Article begins by discussing the obstetrics clinic of Alpha Hospital, (14) a large public hospital in New York City where I conducted a year of ethnographic field research. Noting the hostility and antipathy that characterized interactions between clinic staff (15) and their poor (predominately phenotypically non-White) patients, this Article explores the reproductive rights possessed by patients at the clinic--patients who provoked condemnation and scorn by the mere fact of their pregnancies. Therein, Part I questions the quality of the "reproductive rights" that poor Black women possess, considering that their decision to procreate jettisons them into a reviled and censured social position.

Part II goes on to examine the reproductive rights of poor, pregnant, racially subjugated women by turning to Eva Cherniavsky's brilliant exploration of capitalism and racialization--Incorporations: Race, Nation, and the Body Politics of Capital. (16) Through the lens of postcolonial theory, Cherniavsky analyzes racial embodiment (17) as it occurs in capitalist economic systems. (18) Cherniavsky defines colonies not merely as sites of capitalist expansion, but rather as sites where contradictory economic systems collide and coexist. Under this view, racialized difference is triggered, in part, by the imbrication of economic systems. (19) This Part uses Cherniavsky to argue that the Alpha Hospital obstetrics clinic resembles the classic colony--an analogy that explains the racialization of the women seeking healthcare there.

Moreover, Cherniavsky's work elucidates why the reproductive rights and bodily integrity of Black and other racially subjugated women are compromised at the moment of their exercise. Part III considers Cherniavsky's argument that race ultimately signifies the ability or inability of a body to defend itself against invasive market forces (20)--linking this theory to the mandatory work requirements with which poor women are forced to comply when they receive welfare. This Part criticizes these programs for transforming the Black and racially-subjugated body into a laboring body. A brief conclusion follows.

THE ALPHA OBSTETRICS CLINIC AND THE REPRODUCTIVE RIGHTS OF POOR, BLACK WOMEN

Once described as the "best shot at public health care in the country," (21) Alpha Hospital serves as the backdrop to this Article's ruminations on reproductive rights and racial justice. The vast majority of patients who receive care from Alpha, and who specifically receive care from Alpha's overtaxed obstetrics clinic, are Black and Latina women, including many undocumented immigrants. (22) However, Alpha is remarkable for the sheer diversity of its patients: on any given day, English, Spanish, Arabic, Mandarin, Cantonese, Bengali, French, and Hindi can be overheard in the halls and waiting rooms of the hospital. Most pregnant patients at Alpha are poor, and almost all rely upon Medicaid--specifically the Prenatal Care Assistance Program (PCAP) (23)--to cover the costs of their prenatal healthcare expenses.

From May 2006 until September 2007, I conducted ethnographic research in the obstetrics clinic, participating in and observing its quotidian life. (24) The vantage point from which I made my observations was ever-shifting--moving from the waiting areas to the receptionists' intake desk, to the nurses' triage rooms, to physicians' and midwives' examination rooms, to the offices of social workers, nutritionists, geneticists, health educators, and Medicaid financial officers. Over the course of my research, I compiled over 120 hours of in-depth interviews with patients, staff, and providers who were kind enough to let me ask questions about their experiences at Alpha and, with respect to resident doctors, their experiences at Omega Hospital, the private hospital where they spent half of their time. (25)

Elsewhere I have described the enmity that characterized the relationship between Alpha staff and their patients. (26) In that piece, I concluded that patient-staff hostility--a banality that could be observed whenever one spent more than a passing moment in the hospital--stemmed from the fact that Alpha patients were viewed by the staff as uneducated and unintelligent, yet exceptionally crafty manipulators of the Alpha "system." (27) These contradictory characteristics yielded the fiction of the "wily patient"--a figure who, although dim-witted and simple-minded, is nonetheless capable of shrewdly exploiting the hospital and gaining undeserved healthcare. (28) The wily patient parallels the fictive "welfare queen"--a similarly uneducated and unintelligent woman with the uncanny ability to exploit government beneficence and obtain undeserved cash assistance. That article argued that the...